Provider Demographics
NPI:1467794800
Name:PHELPS, HOLLY ANNE (DVM)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:ANNE
Last Name:PHELPS
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 COSTELLO DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-4310
Mailing Address - Country:US
Mailing Address - Phone:540-450-0711
Mailing Address - Fax:877-334-9594
Practice Address - Street 1:210 COSTELLO DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-4310
Practice Address - Country:US
Practice Address - Phone:540-450-0711
Practice Address - Fax:877-334-9594
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-25
Last Update Date:2016-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA2557174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian